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A shared care agreement outlines the ways in which the responsibilities for managing the prescribing of a medicine can be shared between the specialist and a primary care prescriber. Primary care prescribers are invited to participate. If they are unable to undertake these roles, then he or she is under no obligation to do so. In such an event, the total clinical responsibility for the patient for that diagnosed condition remains with the specialist. Primary care prescribers are advised not to take on prescribing of these medicines unless they have been adequately informed by letter of their responsibilities with regards to monitoring , side effects and interactions and are happy to take on the prescribing responsibility. Primary care prescribers should then inform secondary care of their intentions as soon as possible by letter and then arrange the transfer of care as necessary. This will ensure that their is absolute clarity as to who is taking over the prescribing, and any associated monitoring responsibilities. Sharing of care assumes communication between the specialist, primary care prescriber and the patient. The intention of shared care is usually explained to the patient by the prescriber initiating the treatment. It is important that patients are consulted about treatment and are in agreement with it. Patients should remain under regular follow-up in secondary care, where it is expected that the patients overall response to treatment, and need for continued treatment will be monitored. Prescribers are reminded that the doctor who prescribes the medication legally assumes clinical responsibility for the drug and the consequences of its use.
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